Exercises to improve strength and balance in patients with ischemic stroke
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Published:
Jul 27, 2020
Keywords:
Neurorehabilitation, Stroke, Strength, Balance
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Abstract
Strokes represent one of the highest incidence in the world population. Stroke can bring great disability to the person who suffers it; and it limits it in the activities of daily life, due to the affectation of a hemibody, highlighting the limitations of said activities due to the loss of balance and muscular strength; its approach by the traditional programs does not satisfy the totality of the expectations of specialists and patients, which requires greater attention on the part of the professionals. To help solve this problem, the objective was to develop a battery of exercises to improve strength and balance in patients with ischemic stroke, a sample of 7 patients was taken from the Clinical Adult Brain Injury Clinic of International Center of Neurological Restoration (CIREN) using different methods, which included observation techniques, guidelines for reasoning and forecasting, applied the planned experimentation that showed statistically significant changes in strength and balance. This allowed us to conclude that the battery of exercises was able to improve strength and balance in patients with ischemic strokes.
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Dutill Macurán Y., Echemendía del Valle A., & Núñez Hernández I. (2020). Exercises to improve strength and balance in patients with ischemic stroke. Acción, 16(s/n). Retrieved from https://accion.uccfd.cu/index.php/accion/article/view/115
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References
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Barker, S., Horton, M., Kent, R. M., & Tennant, A. (2013). Development of aself-report scale of spasticity. Top Stroke Rehabil., 20, 485-492.
Canbek, J., Fulk, G., Nof, L., & Echternach, J. (2013). Test-retest reliability and construct validity of the tinetti performance-oriented mobility assessment in people with stroke. J Neurol Phys Ther, 37(1), 14-19. doi:10.1097/NPT.0b013e318283ffcc
Cano, R., & Collado, S. V. (2012). Neurorrehabilitación. Métodos específicos de valoración y tratamiento. Madrid: Medica Panamericana.
Colectivo de especialistas de la Clínica de Lesiones Estáticas. (2000a). Orientaciones metodologicas del programa de rehabilitación fisica lesiones estáticas encefalicas. Centro Internacional de Restauración Neurológica. La Habana.
Colectivo de especialistas de la Clínica de Lesiones Estáticas. (2000b). Programa de Rehabilitación de lesiones estáticas encefalicas. Centro Internacional de Restauración Neurológica. La Habana.
Coll-Costa, J., L , Estévez-Perera, A., Martín-Cordero, J. E., & Estévez-Perera, A. (2011). Resultados de la aplicación de un programa de rehabilitación física en pacientes con síndrome hemipléjico por enfermedad cerebrovascular. Rev Col Med Fis Rehab, 21(2), 68-75.
Coll-Costa, J. D. (2012). Programa de ejercicios físicos terapéuticos para la rehabilitación de pacientes hemipléjicos en la Atención primaria de salud. (Tesis Doctoral), Universidad de Ciencias de la Cultura Física y el Deporte "Manuel Fajardo", La Habana.
Colombo, P., Taveggia, G., Chiesa, D., Penati, R., Tiboni, M., De Armas, L., & Casale, R. (2019). Lower Tinetti scores can support an early diagnosis of spatial neglect in post-stroke patients. Eur J Phys Rehabil Med, 55(6), 722-727. doi:10.23736/S1973-9087.19.05448-0
De Armas, N., & Valle-Lima, A. (2011). Aproximación a la metodología como resultado científico. In I. Salas (Ed.), Los resultados científicos en la investigación educativa (pp. 40-51). La Habana: Pueblo y Educación.
Demetrios, M., Brand, C., Louie, J., & Khan, F. (2016). More than a black box of rehabilitation: Characterizing therapy programmes following botulinum toxin injections for spasticity in adults with stroke. J Rehabil Med, 48(5), 426-434. doi:10.2340/16501977-2085
Demetrios, M., Khan, F., Turner-Stokes, L., Brand, C., & McSweeney, S. (2013). Multidisciplinary rehabilitation following botulinum toxin and other focal intramuscular treatment for post-stroke spasticity. Cochrane Database Syst Rev(6), CD009689. doi:10.1002/14651858.CD009689.pub2
Escalante-Candeaux, L. (2015). Evaluación de la condición física en adultos mayores practicantes sistemáticos. (Tesis Doctoral), Universidad de Ciencias de la Cultura Física y el Deporte "Manuel Fajardo", La Habana.
Faulkner, J., Tzeng, Y. C., Lambrick, D., Woolley, B., Allan, P. D., O'Donnell, T.,. . . Stoner, L. (2017). A randomized controlled trial to assess the central hemodynamic response to exercise in patients with transient ischaemic attack and minor stroke. J Hum Hypertens, 31(3), 172-177. doi:10.1038/jhh.2016.72
Figueroa, J., Villamayor, B., & Antelo, A. (2015). Rehabilitación del ictus cerebral evaluación, pronóstico y tratamiento. In J. Castillo-Sánchez & I. Jiménez-Martín (Eds.), Reeducación funcional tras un ictus (pp. 89-104). Barcelona: Elsevier.
Francica, J. V., Bigongiari, A., Mochizuki, L., Scapini, K. B., Moraes, O. A., Mostarda, C.,. . . Rodrigues, B. (2015). Cardiac autonomic dysfunction in chronic stroke women is attenuated after submaximal exercise test, as evaluated by linear and nonlinear analysis. BMC Cardiovasc Disord, 15, 105. doi:10.1186/s12872-015-0099-9
Hara, T., Abo, M., Hara, H., Kobayashi, K., Shimamoto, Y., Samizo, Y.,. . . Niimi, M. (2017). Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on upper and lower limb spasticity in post-stroke patients. Int J Neurosci, 127(6), 469-478. doi:10.1080/00207454.2016.1196204
Hara, T., Abo, M., Hara, H., Kobayashi, K., Shimamoto, Y., Shibata, Y.,. . . Niimi, M. (2018). Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on lower limb spasticity classified by spastic muscle echo intensity in post-stroke patients. Int J Neurosci , 128(5), 412-420. doi:10.1080/00207454.2017.1389927
Hara, T., Abo, M., Hara, H., Sasaki, N., Yamada, N., Niimi, M., & Shimamoto, Y. (2018). The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients. Toxins (Basel), 10(9). doi:10.3390/toxins10090349
He, Y. L., Gao, Y., & Fan, B. Y. (2019). Effectiveness of neuromuscular electrical stimulation combined with rehabilitation training for treatment of post-stroke limb spasticity. Medicine (Baltimore), 98(39), e17261. doi:10.1097/MD.0000000000017261
Hernández-García, S. (2018). Metodología para la rehabilitación física de pacientes con insuficiencia cardiaca crónica y fracción de eyección del ventrículo izquierdo deprimida. (Tesis Doctoral), Universidad de las Ciencias de la Cultura Física y el Deporte, La Habana.
Heron, N., Kee, F., Cardwell, C., Tully, M. A., Donnelly, M., & Cupples, M. E. (2017). Secondary prevention lifestyle interventions initiated within 90 days after TIA or 'minor' stroke: a systematic review and meta-analysis of rehabilitation programmes. Br J Gen Pract, 67(654), e57-e66. doi:10.3399/bjgp16X688369
Jagroop, D., Maebrae-Waller, A., & Dogra, S. (2018). The feasibility of an exercise program 12 months post-stroke in a small urban community. J Sports Med Phys Fitness, 58(6), 895-902. doi:10.23736/S0022-4707.17.07414-X
Janus-Laszuk, B., Mirowska-Guzel, D., Sarzynska-Dlugosz, I., & Czlonkowska, A. (2017). Effect of medical complications on the after-stroke rehabilitation outcome. NeuroRehabilitation, 40(2), 223-232. doi:10.3233/NRE-161407
Kann, S. (2010). Estrategia para la aplicación de un programa de rehabilitación a pacientes con enfermedades cardiovasculares del Hospital Nacional Donka de Conakry, República de Guinea. (Tesis Doctoral), Universidad de Ciencias de la Cultura Física y el Deporte "Manuel Fajardo", La Habana.
Kenyata-More, J. (2008). La rehabilitación física del paciente hemiparésico crónico en las áreas de cultura física terapéutica y profiláctica. (Tesis Doctoral), Instituto Superior de Cultura Física “Manuel Fajardo”, Santa Clara.
Ordahan, B., Karahan, A. Y., Basaran, A., Turkoglu, G., Kucuksarac, S., Cubukcu, M.,. . . Kuran, B. (2015). Impact of exercises administered to stroke patients with balance trainer on rehabilitation results: a randomized controlled study. Hippokratia, 19(2), 125-130.
Pancorbo, A. E. (2002). Medicina del deporte y ciencias aplicadas al alto rendimiento y la salud. : EDUCS - Editora da Universidade de Caxias do Sul. Brasil.
Puckree, T., & Naidoo, P. (2014). Balance and stability-focused exercise program improves stability and balance in patients after acute stroke in a resource-poor setting. PM R, 6(12), 1081-1087. doi:10.1016/j.pmrj.2014.06.008
Ruiz-Aguilera, A. (1988). Metodología de la enseñanza de la Educación Física. La Habana: Editorial Pueblo y Educación.
Shah, S., Cooper, B., & Maas, F. (1992). The Barthel Index and ADL Evaluation in Stroke Rehabilitation in Australia, Japan, the UK and the USA. Aust Occup Ther J, 39(1), 5-13. doi:10.1111/j.1440-1630.1992.tb01729.x
Sheehy, L., Taillon-Hobson, A., Sveistrup, H., Bilodeau, M., Yang, C., & Finestone, H. (2020). Sitting Balance Exercise Performed Using Virtual Reality Training on a Stroke Rehabilitation Inpatient Service: A Randomized Controlled Study. PM R . doi:10.1002/pmrj.12331
Tanne, D., Tsabari, R., Chechik, O., Toledano, A., Orion, D., Schwammenthal, Y.,. . . Adler, Y. (2008). Improved exercise capacity in patients after minor ischemic stroke undergoing a supervised exercise training program. Isr Med Assoc J, 10(2), 113-116.
Ullberg, T., Zia, E., Petersson, J., & Norrving, B. (2016). Perceived Unmet Rehabilitation Needs 1 Year After Stroke: An Observational Study From the Swedish Stroke Register. Stroke, 47(2), 539-541. doi:10.1161/STROKEAHA.115.011670
Vahlberg, B., Cederholm, T., Lindmark, B., Zetterberg, L., & Hellstrom, K. (2017). Short-term and long-term effects of a progressive resistance and balance exercise program in individuals with chronic stroke: a randomized controlled trial. Disabil Rehabil, 39(16), 1615-1622. doi:10.1080/09638288.2016.1206631
Van der Sande, M. A. B., Walraven, G. E. L., Milligan, P., Banya, W., Ceesay, S., Nyan, O., & McAdam, K. P. (2001). Antecedentes familiares: una oportunidad para intervenir precozmente y mejorar el control de la hipertensión, la obesidad y la diabetes. Boletín de la Organización Mundial de la Salud, 5, 34-40.
Vincent-Onabajo, G., Joseph, E., & Musa, H. Y. (2018). Impact of balance on functional independence after stroke: A cross-sectional study at rehabilitation settings in Nigeria. NeuroRehabilitation , 42(4), 499-504. doi:10.3233/NRE-172305
Zhu, J. M., Zhuang, R., He, J., Wang, X. X., Wang, H., & Zhu, H. Y. (2020). [Yin-yang balance penetrating acupuncture combined with rehabilitation training on upper limb spasticity in stroke hemiplegia]. Zhongguo Zhen Jiu, 40(7), 697-701. doi:10.13703/j.0255-2930.20190531-k0005
Zimmerli, L., Krewer, C., Gassert, R., Muller, F., Riener, R., & Lunenburger, L. (2012). Validation of a mechanism to balance exercise difficulty in robot-assisted upper-extremity rehabilitation after stroke. J Neuroeng Rehabil, 9, 6. doi:10.1186/1743-0003-9-6
Barker, S., Horton, M., Kent, R. M., & Tennant, A. (2013). Development of aself-report scale of spasticity. Top Stroke Rehabil., 20, 485-492.
Canbek, J., Fulk, G., Nof, L., & Echternach, J. (2013). Test-retest reliability and construct validity of the tinetti performance-oriented mobility assessment in people with stroke. J Neurol Phys Ther, 37(1), 14-19. doi:10.1097/NPT.0b013e318283ffcc
Cano, R., & Collado, S. V. (2012). Neurorrehabilitación. Métodos específicos de valoración y tratamiento. Madrid: Medica Panamericana.
Colectivo de especialistas de la Clínica de Lesiones Estáticas. (2000a). Orientaciones metodologicas del programa de rehabilitación fisica lesiones estáticas encefalicas. Centro Internacional de Restauración Neurológica. La Habana.
Colectivo de especialistas de la Clínica de Lesiones Estáticas. (2000b). Programa de Rehabilitación de lesiones estáticas encefalicas. Centro Internacional de Restauración Neurológica. La Habana.
Coll-Costa, J., L , Estévez-Perera, A., Martín-Cordero, J. E., & Estévez-Perera, A. (2011). Resultados de la aplicación de un programa de rehabilitación física en pacientes con síndrome hemipléjico por enfermedad cerebrovascular. Rev Col Med Fis Rehab, 21(2), 68-75.
Coll-Costa, J. D. (2012). Programa de ejercicios físicos terapéuticos para la rehabilitación de pacientes hemipléjicos en la Atención primaria de salud. (Tesis Doctoral), Universidad de Ciencias de la Cultura Física y el Deporte "Manuel Fajardo", La Habana.
Colombo, P., Taveggia, G., Chiesa, D., Penati, R., Tiboni, M., De Armas, L., & Casale, R. (2019). Lower Tinetti scores can support an early diagnosis of spatial neglect in post-stroke patients. Eur J Phys Rehabil Med, 55(6), 722-727. doi:10.23736/S1973-9087.19.05448-0
De Armas, N., & Valle-Lima, A. (2011). Aproximación a la metodología como resultado científico. In I. Salas (Ed.), Los resultados científicos en la investigación educativa (pp. 40-51). La Habana: Pueblo y Educación.
Demetrios, M., Brand, C., Louie, J., & Khan, F. (2016). More than a black box of rehabilitation: Characterizing therapy programmes following botulinum toxin injections for spasticity in adults with stroke. J Rehabil Med, 48(5), 426-434. doi:10.2340/16501977-2085
Demetrios, M., Khan, F., Turner-Stokes, L., Brand, C., & McSweeney, S. (2013). Multidisciplinary rehabilitation following botulinum toxin and other focal intramuscular treatment for post-stroke spasticity. Cochrane Database Syst Rev(6), CD009689. doi:10.1002/14651858.CD009689.pub2
Escalante-Candeaux, L. (2015). Evaluación de la condición física en adultos mayores practicantes sistemáticos. (Tesis Doctoral), Universidad de Ciencias de la Cultura Física y el Deporte "Manuel Fajardo", La Habana.
Faulkner, J., Tzeng, Y. C., Lambrick, D., Woolley, B., Allan, P. D., O'Donnell, T.,. . . Stoner, L. (2017). A randomized controlled trial to assess the central hemodynamic response to exercise in patients with transient ischaemic attack and minor stroke. J Hum Hypertens, 31(3), 172-177. doi:10.1038/jhh.2016.72
Figueroa, J., Villamayor, B., & Antelo, A. (2015). Rehabilitación del ictus cerebral evaluación, pronóstico y tratamiento. In J. Castillo-Sánchez & I. Jiménez-Martín (Eds.), Reeducación funcional tras un ictus (pp. 89-104). Barcelona: Elsevier.
Francica, J. V., Bigongiari, A., Mochizuki, L., Scapini, K. B., Moraes, O. A., Mostarda, C.,. . . Rodrigues, B. (2015). Cardiac autonomic dysfunction in chronic stroke women is attenuated after submaximal exercise test, as evaluated by linear and nonlinear analysis. BMC Cardiovasc Disord, 15, 105. doi:10.1186/s12872-015-0099-9
Hara, T., Abo, M., Hara, H., Kobayashi, K., Shimamoto, Y., Samizo, Y.,. . . Niimi, M. (2017). Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on upper and lower limb spasticity in post-stroke patients. Int J Neurosci, 127(6), 469-478. doi:10.1080/00207454.2016.1196204
Hara, T., Abo, M., Hara, H., Kobayashi, K., Shimamoto, Y., Shibata, Y.,. . . Niimi, M. (2018). Effects of botulinum toxin A therapy and multidisciplinary rehabilitation on lower limb spasticity classified by spastic muscle echo intensity in post-stroke patients. Int J Neurosci , 128(5), 412-420. doi:10.1080/00207454.2017.1389927
Hara, T., Abo, M., Hara, H., Sasaki, N., Yamada, N., Niimi, M., & Shimamoto, Y. (2018). The Effect of Repeated Botulinum Toxin A Therapy Combined with Intensive Rehabilitation on Lower Limb Spasticity in Post-Stroke Patients. Toxins (Basel), 10(9). doi:10.3390/toxins10090349
He, Y. L., Gao, Y., & Fan, B. Y. (2019). Effectiveness of neuromuscular electrical stimulation combined with rehabilitation training for treatment of post-stroke limb spasticity. Medicine (Baltimore), 98(39), e17261. doi:10.1097/MD.0000000000017261
Hernández-García, S. (2018). Metodología para la rehabilitación física de pacientes con insuficiencia cardiaca crónica y fracción de eyección del ventrículo izquierdo deprimida. (Tesis Doctoral), Universidad de las Ciencias de la Cultura Física y el Deporte, La Habana.
Heron, N., Kee, F., Cardwell, C., Tully, M. A., Donnelly, M., & Cupples, M. E. (2017). Secondary prevention lifestyle interventions initiated within 90 days after TIA or 'minor' stroke: a systematic review and meta-analysis of rehabilitation programmes. Br J Gen Pract, 67(654), e57-e66. doi:10.3399/bjgp16X688369
Jagroop, D., Maebrae-Waller, A., & Dogra, S. (2018). The feasibility of an exercise program 12 months post-stroke in a small urban community. J Sports Med Phys Fitness, 58(6), 895-902. doi:10.23736/S0022-4707.17.07414-X
Janus-Laszuk, B., Mirowska-Guzel, D., Sarzynska-Dlugosz, I., & Czlonkowska, A. (2017). Effect of medical complications on the after-stroke rehabilitation outcome. NeuroRehabilitation, 40(2), 223-232. doi:10.3233/NRE-161407
Kann, S. (2010). Estrategia para la aplicación de un programa de rehabilitación a pacientes con enfermedades cardiovasculares del Hospital Nacional Donka de Conakry, República de Guinea. (Tesis Doctoral), Universidad de Ciencias de la Cultura Física y el Deporte "Manuel Fajardo", La Habana.
Kenyata-More, J. (2008). La rehabilitación física del paciente hemiparésico crónico en las áreas de cultura física terapéutica y profiláctica. (Tesis Doctoral), Instituto Superior de Cultura Física “Manuel Fajardo”, Santa Clara.
Ordahan, B., Karahan, A. Y., Basaran, A., Turkoglu, G., Kucuksarac, S., Cubukcu, M.,. . . Kuran, B. (2015). Impact of exercises administered to stroke patients with balance trainer on rehabilitation results: a randomized controlled study. Hippokratia, 19(2), 125-130.
Pancorbo, A. E. (2002). Medicina del deporte y ciencias aplicadas al alto rendimiento y la salud. : EDUCS - Editora da Universidade de Caxias do Sul. Brasil.
Puckree, T., & Naidoo, P. (2014). Balance and stability-focused exercise program improves stability and balance in patients after acute stroke in a resource-poor setting. PM R, 6(12), 1081-1087. doi:10.1016/j.pmrj.2014.06.008
Ruiz-Aguilera, A. (1988). Metodología de la enseñanza de la Educación Física. La Habana: Editorial Pueblo y Educación.
Shah, S., Cooper, B., & Maas, F. (1992). The Barthel Index and ADL Evaluation in Stroke Rehabilitation in Australia, Japan, the UK and the USA. Aust Occup Ther J, 39(1), 5-13. doi:10.1111/j.1440-1630.1992.tb01729.x
Sheehy, L., Taillon-Hobson, A., Sveistrup, H., Bilodeau, M., Yang, C., & Finestone, H. (2020). Sitting Balance Exercise Performed Using Virtual Reality Training on a Stroke Rehabilitation Inpatient Service: A Randomized Controlled Study. PM R . doi:10.1002/pmrj.12331
Tanne, D., Tsabari, R., Chechik, O., Toledano, A., Orion, D., Schwammenthal, Y.,. . . Adler, Y. (2008). Improved exercise capacity in patients after minor ischemic stroke undergoing a supervised exercise training program. Isr Med Assoc J, 10(2), 113-116.
Ullberg, T., Zia, E., Petersson, J., & Norrving, B. (2016). Perceived Unmet Rehabilitation Needs 1 Year After Stroke: An Observational Study From the Swedish Stroke Register. Stroke, 47(2), 539-541. doi:10.1161/STROKEAHA.115.011670
Vahlberg, B., Cederholm, T., Lindmark, B., Zetterberg, L., & Hellstrom, K. (2017). Short-term and long-term effects of a progressive resistance and balance exercise program in individuals with chronic stroke: a randomized controlled trial. Disabil Rehabil, 39(16), 1615-1622. doi:10.1080/09638288.2016.1206631
Van der Sande, M. A. B., Walraven, G. E. L., Milligan, P., Banya, W., Ceesay, S., Nyan, O., & McAdam, K. P. (2001). Antecedentes familiares: una oportunidad para intervenir precozmente y mejorar el control de la hipertensión, la obesidad y la diabetes. Boletín de la Organización Mundial de la Salud, 5, 34-40.
Vincent-Onabajo, G., Joseph, E., & Musa, H. Y. (2018). Impact of balance on functional independence after stroke: A cross-sectional study at rehabilitation settings in Nigeria. NeuroRehabilitation , 42(4), 499-504. doi:10.3233/NRE-172305
Zhu, J. M., Zhuang, R., He, J., Wang, X. X., Wang, H., & Zhu, H. Y. (2020). [Yin-yang balance penetrating acupuncture combined with rehabilitation training on upper limb spasticity in stroke hemiplegia]. Zhongguo Zhen Jiu, 40(7), 697-701. doi:10.13703/j.0255-2930.20190531-k0005
Zimmerli, L., Krewer, C., Gassert, R., Muller, F., Riener, R., & Lunenburger, L. (2012). Validation of a mechanism to balance exercise difficulty in robot-assisted upper-extremity rehabilitation after stroke. J Neuroeng Rehabil, 9, 6. doi:10.1186/1743-0003-9-6